The enormous public health threat created by driving under the influence of intoxicants (DUI), coupled with the current stability in the rates of this behavior and its consequences, requires researchers and treatment providers to learn more about the psychosocial profiles, including the cognitions and beliefs of DUI offenders in general and repeat DUI offenders in particular. This understanding is crucial if we are to develop effective treatments for DUI. Our R01 project (1 R01 AA014710-01A1) pursued the former course of action, assessing and analyzing psychiatric disorders and comorbidity among repeat DUI offenders. That study and others have found reliable and significant links between psychiatric comorbidity and DUI offending. However, very few studies have examined the more proximal cognitive predictors of DUI behavior. These cognitive factors, and their interaction with psychosocial variables, might prove to be important targets for DUI intervention. To investigate these proximal cognitive predictors, this R03 application requests support for two years to conduct a secondary analysis of the explanations for their DUI behavior generated by repeat DUI offenders as part of our original NIAAA-funded study, Toward Evidence Based Treatments to Reduce DUI Relapse (1 R01 AA014710-01A1). That study used the Composite International Diagnostic Interview (CIDI) to examine prospectively the relationship between psychiatric disorder profiles and DUI among repeat DUI offenders. It included the collection of baseline (N=779) and one-year follow-up data (N=480) from inpatient court-mandated treatment-seeking multiple DUI offenders, as well as follow-up data from a subsample of collateral informants (N=80). The proposed R03 study seeks to analyze the offenders'free-response explanations, generated at follow-up, in terms of content, language structure, and attributional elements, to explore how repeat offenders'understanding of their DUI behavior relates to the perpetuation of that behavior as well as the more distal predictors of the behavior. Specifically, this study will (a) identify how these offenders understand and describe their behavior (compared to collateral informants explaining these same offender behaviors), (b) investigate the relationship between these proximal cognitive predictors and offenders'recidivism, and (c) explore how offenders'understanding of their behavior relates to their mental health and how that interaction, in turn, relates to DUI recidivism. PUBLIC HEALTH RELEVANCE: This proposed R03 study will examine components of the explanations repeat DUI offenders offer for their offenses. By studying the way repeat DUI offenders understand (and/or describe) their own behavior, we can learn about both potential influences on their behavior, and the attributions they make for their own behavior (i.e., whether those attributions incorporate systematic biases or relate predictably to recidivism and mental health). Knowing the range of reasons offered by DUI offenders in treatment is useful in its own right for treatment programs, since such knowledge is currently unavailable and can identify important targets for intervention. For example, if the majority of offenders offer lack of transportation as a reason for offending, that leads to different types of interventions than if the majority claim that they enjoy the thrill of engaging in risky behaviors. Further, if attributional biases relate to recidivism and mental health in this population, targeting those biases along with the mental health issues to which they correspond, might improve clinical outcomes.